Endoscopic Imaging System Uses Light Scattering to Identify Precancer
Researchers have developed a system that can survey the entire esophageal lining and detect precancerous sites.
Esophageal adenocarcinoma, one of the two main types of esophageal cancer, has a very poor prognosis, with less than 16 percent survival after five years. Detecting the disease early, while it is still in a precancerous stage -- a condition called dysplasia -- does increase the likelihood of a better outcome. However, traditional optical endoscopy isn't able to detect dysplasia, and systematic biopsies only sample a tiny proportion of the esophageal lining.
As an alternative method, a team of researchers from Harvard University has developed an endoscopic imaging system which surveys the entire esophageal lining and can identify dysplastic sites. The instrument uses light scatting spectroscopy, a technique that analyzes light scattered from epithelial cells to provide information about early precancerous changes. The results were published April 6 in the journal Light: Science & Applications.
The imaging system consists of a multichannel spectrometer, broadband bright LED light source, and a fiber optic probe. During the clinical procedure, the probe is inserted into the esophagus through an endoscope and then performs rapid automated rotational and longitudinal scanning of the entire esophagus.
The authors evaluated the instrument's performance in a double-blind study with 57 patients with Barrett's esophagus, a condition that puts people at high risk for dysplasia. They compared findings from the new imaging system with pathology results at each location where biopsies were collected. Overall, 55 out of 57 patients were diagnosed correctly by the system. Also, in a subset of 24 patients, the system was able to identify individual dysplastic sites with 90 percent accuracy.